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Recommended thread Compassionate Communication with the Memory Impaired

Discussion in 'Health and wellbeing' started by Grannie G, Jan 24, 2011.

  1. kimhatton

    kimhatton Registered User

    By far the best approach to dementia

    I welcome this post as not only the most compassionate but the most sensible and realistic approach for someone caring for someone with Dementia. I wish my sister could have read and used it but she was sure that 'despite the dementia' my mother 'knew what she was doing/saying and meant to be hurtful and awkward'.
  2. WendyJ

    WendyJ Registered User

    Jul 29, 2009
    That is so helpful. Thank you very much.

    I got to the stage this week of wondering to myself why I was bothering to mess up every weekend by visiting someone who is not in any way related to me and who seems to just want to be difficult and argumentative.

    That post has put it all in perspective and has given me something to hold on to.

    It seems obvious, doesn't it? But it isn't when you are locked into an argument - especially if you are, like me, someone who always wants to be right :D

    Thanks again. :)
  3. jumzya

    jumzya Registered User

    Dec 17, 2010
    Thanks for this.Just what i was looking for, very handy :cool:
  4. Jancis

    Jancis Registered User

    Jun 30, 2010
    I am a mac user and good news - we can read .doc files - as we use microsoft word too! So glad to have printed this version to give to my family. Wish I had read it a long long time ago.
  5. miladysom

    miladysom Registered User

    Sep 29, 2010
    Compassion is what is needed!

    I found such comfort in reading this thread on communicating with the memory impaired. I am humbled when realising how much I am getting wrong, and can't wait to put some of right. You have made me realise just how unsensitive I am being in trying to reason. The main thing is we can still find the love that is always there. Thankyou so much for whoever put this together.
  6. boatlady

    boatlady Registered User

    Mar 25, 2010
    Compassionate care for the memory impaired

    Thank you so much for this article - it has reminded me of how my Dad needs me to be. I hope it is ok if I share it with the carers at my dad's nursing home.
  7. CollegeGirl

    CollegeGirl Registered User

    Jan 19, 2011
    North East England
    Thank you for posting this information.

    I tried out the repeating exactly advice last week when I was looking after my mam while dad had a break. She kept saying "I hope your dad comes home", to which I kept replying "of course he will, he's just gone for a pint".

    After the third time, she said "I know - you've said that three times now!" It did make me laugh.

    I don't know if this is the desired result - she at least did remember what I'd been saying! Or whether I'd irritated her by repeating myself!
  8. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    It made me laugh too. :D Well done. :)
  9. For the parish magazine

    I don't know whether anyone would like to see it, but this is what I'm thinking of sending to our local parish magazine after the editor wasted 2 pages last month on a "jokey" "Memory test for dementia" item! I'm thinking/hoping she probably isn't going to trouble about copyright issues. Any comments? I've anonymised it a bit so that Mother won't recognise it as definitely being by me.



    As a carer for a family member who has Alzheimer’s, I’d like to offer a counterbalance to last month’s jokey piece about dementia.

    Yes, we all have “senior moments”, even if we don’t have our bus pass yet – but there is a huge difference between that and the state of someone who can go out for a day and remember nothing except the car drive home, or who asks what’s for tea, and asks again 5 minutes later, and again, and again, or who can’t remember that their husband or wife is dead and no longer recognises their own children.

    If you are worried about your memory, or that of a friend or family member, please talk to your GP, ring the Alzheimer’s Society helpline on 0845 300 0336 (8.30-6.30 Mon-Fri) or look at their website on http://www.alzheimers.org.uk/. The society is concerned with all forms of dementia, not just Alzheimer’s: the local branch is based in Morecambe and has regular carers’ meetings.

    On the Alzheimer’s Society carers’ website someone recently shared the following wisdom. For a fuller version please see http://www.alaskabraininjury.org/library (search on “Compassionate”).

    Extracts from : Compassionate Communication with the Memory Impaired by Liz Ayre

    Don’t reason.
    Don’t argue.
    Don’t confront.
    Don’t remind them they forget.
    Don’t question recent memory.
    Don’t take it personally.

    Give short, one sentence explanations.
    Allow plenty of time for comprehension, then triple it.
    Repeat instructions or sentences exactly the same way.
    Eliminate 'but' from your vocabulary; substitute 'nevertheless.'
    Avoid insistence. Try again later
    Agree with them or distract them to a different subject or activity
    Accept blame when something’s wrong (even if it’s fantasy).
    Leave the room, if necessary, to avoid confrontations.
    Respond to feelings rather than words
    Be patient and cheerful and reassuring. Do go with the flow.
    Practice 100% forgiveness. Memory loss progresses daily.
    My appeal to you: Please.elevate your level of generosity and graciousness.


    You can’t control memory loss, only your reaction to it. Compassionate communication will significantly heighten quality of life.

    They are not crazy or lazy. They say normal things, and do normal things, for a memory impaired, dementia individual. If they were deliberately trying to exasperate you, they would have a different diagnosis. Forgive them ... always.

    Their disability is memory loss. Asking them to remember is like asking a blind person to read. (“Did you take your pills?” “What did you do today?”) Don’t ask and don’t test memory! A loss of this magnitude reduces the capacity to reason. Expecting them to be reasonable or to accept your conclusion is unrealistic. (“You need a shower.” “Day care will be fun.” “You can’t live alone.”) Don’t try to reason or convince them. Give a one sentence explanation or search for creative solutions. Memory loss produces unpredictable emotions, thought, and behavior, which you can alleviate by resolving all issues peacefully. Don’t argue, correct, contradict, confront, blame, or insist.

    Open-ended questions (“Where shall we go?” “What do you want to eat/wear/do?”) are surprisingly complex and create anxiety. Give them a simple choice between two items or direct their choice, “You look great in the red blouse.”

    They are scared all the time. Each patient reacts differently to fear. They may become passive, uncooperative, hostile, angry, agitated, verbally abusive, or physically combative. They may even do them all at different times, or alternate between them. Anxiety may compel them to shadow you (follow everywhere). Anxiety compels them to resist changes in routine, even pleasant ones. Your goal is to reduce anxiety whenever possible. Also, they can’t remember your reassurances. Keep saying them.

    I and many other carers on that website found this a very helpful reminder of the way we should talk to the people we care for who have memory impairment. Please bear it in mind when you meet family, friends or strangers who are suffering from this life-shattering disability. It’s no laughing matter.

    A carer in the village

    The editor didn't reply to my initial email, and I haven't quite psyched myself up to ring her up yet - the vicar disowns any editorial responsibility for the magazine!

    It's probably too long, but I'll give it a try. Any comments?

  10. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    #90 jenniferpa, Feb 2, 2011
    Last edited: Feb 2, 2011
  11. Helen33

    Helen33 Registered User

    Jul 20, 2008
    Dear Pam,

    I think it is excellent and I do hope that they publish it. It could be centre pages and in that way it wont be too long.

    If they are really worried about space, you could ask that they publish the first part one month and the second part the following month which might even be better in some ways as it will give continuity.

    I do admire your dedication to getting the message across:)

    Love and looking forward to hearing how you get on.
  12. #92 PamD, Feb 2, 2011
    Last edited: Feb 2, 2011
    Hi Jennifer: I think the reason I chose the Alaska one was that it was the only remotely human-friendly route! With limited space in a print publication I couldn't face using the ghastly URLs from Agelessdesign - and I've just tried their search on "Ayre" and "Compassionate" and it fails both. Pity. Thanks for the thoughts, anyway. Pam

    PS I've just emailed them to point out that their search doesn't work! Ahah, that's reminded me to ring the council about a non-working streetlight I've been whinging about for ages too. Busy day. Mother at Day Centre!
  13. piedwarbler

    piedwarbler Registered User

    Aug 3, 2010
    South Ribble
    I don't know if this has been suggested as I haven't read the entire thread but I'd love to see this thread made sticky. I think it's brilliant x
  14. mazzi

    mazzi Registered User

    Feb 9, 2010
    That probably answered every question i will ever have to ask.I put my very first thread on the forum today and this gave me my answer, thankyou for re-posting it, i am going to print it off and think about it every time i get frustrated with mum. I feel better already and will face tomorrow less stressed xx
  15. Jancis

    Jancis Registered User

    Jun 30, 2010
    Great idea Pied, Yes please make this sticky and ensure that it is quoted often to all new members who are dealing with the terrible dilemma when they come on board here.
  16. Margarita

    Margarita Registered User

    Feb 17, 2006
    #96 Margarita, Feb 5, 2011
    Last edited: Feb 5, 2011
    Gosh it was I that fist posted it on Talking point back in 2006 ,what Sylvia:D posted on the first post in this thread .


    Before finding talking point back in 06 I found USA Alzheimers Society forum and it was in their that Liz posted it . So I ask her if she would not mind me posting it in hear .
  17. Short link to original at "Agelessdesign"

    I think I've managed to create a short link for the web address to link to the original document - this should work: http://tinyurl.com/compcomms ... just tried it, it seems to do! Wonderful! First time I've tried using this "tinyurl" procedure. Pam
  18. Getting copyright permission

    I emailed "Ageless Design", where it seems to have been first published, to ask permission to reproduce the piece in our parish magazine (explaining that it was a low-circulation non-profit publication) and had a reply saying "It is our pleasure to grant you the permission."

    So if you want to republish it anywhere, just email Ellen Warner at ewarner@alzstore.com and ask.

    Too late for this month's issue of our magazine, and I'm not quite sure what garbled version of my several communications the editor is going to publish - I've asked her not to include my name, as Mother reads the magazine and I don't want her to associate her "memory problems" with worse situations. I await the publication with some trepidation (going by the garbled mess she published as an obituary notice for my father ... !). But, as ever, it might be a case of "If you think you can do a better job as editor, then volunteer to do it yourself.", and I'm not willing to take it on (as only a temporary resident in the village - at least in theory, while we care for Mother - and not a churchgoer either!)

  19. Logan

    Logan Registered User

    Nov 1, 2010
    I had a need to speak

    This is confession time for me. There was a real need today to speak with hubby about a particular matter, which needed his acknowledgment and understanding. I was so careful how I said it, when I said it etc etc. So gently said. That did it!!! Shouting and abusive words etc etc towards me. Had to leave him alone in room - he was ok twenty minutes later, but lots of sighs from him. Lx
  20. can I print this

    thanks so much, it is really relevant, can I print it off so I can send it my brother in law cos I've tried to talk tactics with him but he doesn't listen and takes all his Mums comments so personally, I know there is history but she does have what she has and it ain't going to get better,

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